Commissure Attachments for Prosthetic Heart Valves

A tricuspid annuloplasty ring for repairing the tricuspid valve in the heart. The ring is asymmetrically ovoid in shape with discontinuous ends separated by a gap. One end attaches to the annulus near the septal commissure and the other end attaches near the septal leaflet. The ring curves outward toward the inflow side at one end to accommodate the aortic bulge into the annulus. The ring has varying flexibility with a hinge point between segments. This design better conforms to the tricuspid annulus shape and reduces stress on the attachment sutures while avoiding passing through critical structures.

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Prosthetic heart valve design with reduced stress on the leaflets to improve durability. The valve has a collapsible and expandable stent with features that indirectly attach the leaflets to reduce stress compared to directly attaching them. The attachment features are rectangular structures with a central aperture. A fabric is folded over the top strut and sutured through the aperture to connect the inner and outer layers. The fabric extends around side struts for some attachment features. This indirect attachment reduces stress on the leaflets during loading compared to direct attachment.

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Anchoring a medical device like a heart valve replacement using tether attachment members that have locking mechanisms to secure the tethers without piercing tissue. The tether attachment members have channels through which the valve tethers pass. A locking pin inside the channel can move to engage the tether and secure it. This allows easy insertion of the tether and then locking it in place without piercing tissue like staples. The locking pins can be actuated to move in and out of the channel. The tether attachment members can be positioned adjacent to puncture sites in the heart wall to anchor the valve tethers and close the punctures.

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Steerable catheter system for repairing heart valves with multiple steerable catheters that can be precisely positioned relative to each other for valve annulus implantation. The system has two catheters: a main catheter with a bent distal end and a smaller catheter that can slide through the main catheter and expose its distal end. By bending the main catheter, the smaller catheter's distal end can be driven into the valve annulus. Straightening the main catheter exposes more of the smaller catheter. This allows sequential anchoring of multiple locations in the annulus using separate anchors from different catheters.

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A lightweight, single-piece device for fixing cardiac valve leaflets to treat regurgitation. The device has a biased, closed configuration where tissue engaging surfaces are held adjacent by a force sufficient to grasp leaflets. A delivery tool with spreaders can translate the surfaces between open and closed to capture leaflets. The single-piece design reduces weight and components compared to multi-part devices. The device's shape memory bias force enables secure leaflet fixation without excess weight.

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Tissue anchors for cardiac valve repair that have features for easier delivery, improved anchoring, and visual confirmation of successful implantation. The anchors have shaped eyelets for sliding along wires/sutures during delivery, spacers to compress during implantation, and heads that deform to indicate successful anchoring. The spacers prevent excess wire/suture from protruding and the heads compress against the tissue. The eyelets have tapered sections to slide smoothly along wires/sutures when aligned and orthogonal. The anchors can also have locking mechanisms to secure the sutures after annuloplasty.

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A suture lock assembly for securing sutures during implantation of medical devices like prosthetic heart valves. The assembly has a tensioner that can rotate to gather suture length. It also has a quick release mechanism to lock and unlock the suture end. This allows sutures to be securely tightened, then released for easy removal after device implantation. The assembly is integrated into the delivery apparatus for the implantable device.

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Anchoring device and system for securing a prosthetic heart valve to tissue without the need for sutures. The anchoring device consists of a surgical anchor with a distal tip to pierce tissue and a proximal head to engage the valve. The anchor is deployed through the valve into adjacent tissue, then the head is brought into contact with the valve to approximate it. Tension in the anchor pulls the valve into place. The system uses a deployment device with rotating arms to drive anchors into tissue. The valve itself has malleable inflow cells, rigid annular cells, and rigid leaflet posts to allow tissue ingrowth.

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Device and method for securing a prosthetic heart valve at a native valve like the mitral valve. The device is an expandable anchor with a lower portion in the ventricle and an upper portion in the atrium. The lower portion clamps the leaflets using protrusions. The upper portion supports the atrium. The prosthetic valve is inserted inside the native valve and expanded to clamp against the lower anchor. This fixes the prosthetic valve in place without compressing the native annulus.

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Split type precisely anchorable transcatheter mitral valve system for minimally invasive mitral valve replacement. The system comprises two parts: a split mitral valve anchoring stent and a separate split transcatheter artificial mitral valve. The anchoring stent is delivered first to the mitral valve site and engaged with the native valve tissue. Then the transcatheter valve is inserted and expands, causing the anchoring stent to deform and further bind to the valve. This allows personalized valve positioning and support without needing a single integrated device. The stent shape is customized based on patient anatomy. The stent deforms from a funnel to cylindrical shape during valve expansion.

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Expandable prosthetic heart valves that better secure to and remodel the valve annulus to improve performance compared to traditional expandable valves. The valves have anchors that engage surrounding tissue when deployed. These anchors can be separate components or integrated into the valve body. They pull inward during valve expansion to constrict the annulus. This reduces the valve size and pulls the annulus tissue inward as well. The anchors can also be constricted separately using external mechanisms. The valve construction allows treating large annuli with fewer valve sizes and reducing device profile.

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Delivery systems and methods for anchoring medical devices like tissue anchors in the heart. The systems have flexible inner shafts enclosed in rigid outer shafts. This allows flexible delivery through curved paths, then rigid anchoring once in place. The inner shaft can split or separate from the outer shaft when torque resistance is reached, indicating anchoring.

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Prosthetic heart valves with improved sealing and anchoring to native valves, particularly for minimally invasive implantation. The valves have features like radial flanges, conformable structures, offset sealing sections, and distal anchor configurations to better match irregular native valves and promote sealing and anchoring. They can also have docking mechanisms to simplify implantation. The valves can be delivered through smaller incisions compared to open heart surgery.

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A locking ferrule with a one-way locking mechanism for tensionable knotless cardiac valve procedures. The ferrule has a cannulation with locking barbs that engage a suture after it is passed through. This allows tensioning the suture in one direction and then locking it in place to prevent movement. It enables securing sutures in cardiac valve procedures without knots for tensioning and stabilization. The ferrule can be loaded with a suture and then moved to the valve tissue where it is tensioned and locked in place.

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Minimally invasive procedure to reshape heart valves and subvalvular tissue using a multi-opening guide catheter. The catheter has multiple openings spaced closely together. An anchor with a tether attaches to the heart tissue through one opening. The catheter then releases the tether to secure the anchor in place. This allows multiple anchors to be delivered and positioned through the closely spaced openings. The catheter holds the tethers during delivery and release. This stabilizes the device during implantation compared to openings far apart where the tethers would swing freely.

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A split-design transcatheter valve-in-ring system for treating valve failure after annuloplasty ring implantation. The system comprises a customizable anchoring stent and a detachable transcatheter valve. The anchoring stent matches the annuloplasty ring shape and anchors to it. The valve expands inside the stent to anchor there. This prevents valve leakage by accurately fitting the annuloplasty ring and anchoring to the subvalvular tissue. It also allows customization based on patient-specific imaging.

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A low profile, balloon expandable artificial prosthetic aortic valve for transcatheter implantation that aims to address some limitations of current transcatheter aortic valve replacement (TAVR) devices. The valve design involves a cylindrical frame with a cuff made of a polymer material that is integrally attached to the frame. The cuff covers the frame both inside and outside in the supporting section. This provides a one-piece construction that eliminates the need for separate leaflets, commissure masts, or sewing steps to attach the leaflets to the frame. It aims to simplify the valve design, reduce manufacturing time and cost, and potentially improve durability compared to using separate leaflets and sewing them to the frame.

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A prosthetic heart valve system with reduced stress on the leaflets during operation to improve durability. The valve system has a unique attachment method between the leaflets, cuffs, stents, buffers, and commissure features to reduce stresses in the leaflet material. This involves folding the leaflet attachment regions adjacent to the commissure attachment features to allow stress reduction, redistribution, and dampening during valve operation. This helps prevent leaflet tearing and failure over time due to the high stresses encountered during valve opening and closing.

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Expandable prosthetic heart valves with outer skirts that reduce push forces during implantation through delivery sheaths. The skirts have axially extending portions covering commissures at the valve outflow end. This provides a smoother surface at the outflow for easier delivery through vessels. The skirts also seal against native tissue upon expansion. The skirts can have features like tapered extensions, stitch lines, and wrapping around inflow struts to facilitate delivery and reduce paravalvular leakage.

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Reducing stress on leaflets of transcatheter heart valves to improve durability and longevity by allowing deflection at attachment points. The technique involves using patches, billowing patches, or flexible intermediate materials between the leaflets, cuffs, and stents to enable localized movement of the leaflets during valve operation. This reduces stress concentrations in high-stress regions like commissures, preventing leaflet damage and failure over time.

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